Evaluation of a Comprehensive Pain Management Program in a Hospital Inpatient Setting

2.50
Hdl Handle:
http://hdl.handle.net/10755/158302
Type:
Presentation
Title:
Evaluation of a Comprehensive Pain Management Program in a Hospital Inpatient Setting
Abstract:
Evaluation of a Comprehensive Pain Management Program in a Hospital Inpatient Setting
Conference Sponsor:Western Institute of Nursing
Conference Year:2003
Author:Dingmann, Colleen
P.I. Institution Name:University of Colorado Health Science Center, School of Nursing
Title:Research Coordinator
Contact Address:4200 East 9th Avenue, Denver, CO, 90095-6917, USA
Contact Telephone: 303.372.6310
Co-Authors:Fink, R.; Beezley-Hester, J
Statement of the Problem: Recognition of a widespread inadequacy of pain management has prompted corrective efforts within multiple health care disciplines. The Joint Commission on Accreditation of Healthcare Organizations published standards for pain assessment and management in hospitals. A university hospital implemented a comprehensive pain management program, which included the identification of pain as the “fifth vital sign” and documentation requirements for all health care providers. This study evaluated the pain management program and explored the impact of pain interference with functional status and its usefulness as an outcome measure of optimal pain management. Theoretical Framework: This study was guided by Melzack’s Neuromatrix theory and Roger’s Diffusion of Innovation model. Sample: A random sample consisted of 386 inpatients pre- (1994) and 382 inpatients post-implementation (2002) of a comprehensive pain management program. Methods: A prospective comparative design was used to study inpatients who were experiencing pain and had been hospitalized for greater than 24 hours. An 18-item survey, previously developed and tested for reliability and validity, was used to survey inpatients’ knowledge and beliefs about pain, pain intensity, pain interference with functional status, pain expectations, and satisfaction with pain management. Medical records were reviewed for diagnoses, pain types, documentation of pain assessment, analgesic prescription and administration, use of non-pharmacological approaches, and presence of side effects. Findings: Descriptive statistics and tests of difference and association were used to analyze data. Demographics for both populations were similar. Pain intensity scores were not improved post implementation of the pain management program. There was no significant difference in current pain intensity, however, patients’ pain intensity within the past 24 hours, concern about addiction, and perception of their own involvement in pain management showed a significant increase (p<0.01) post implementation. Nurses’ documentation of pain assessment significantly improved (p< 0.01) but remained the same for physicians. Pain interfered with functional status (sleep, walking, mood, and relations with others) in greater than 75% of respondents. Pain intensity was moderately correlated with sleep and walking (p < 0.01). Conclusions: Innovations in pain management practices must be developed to change the culture of persistent attitudes and beliefs about pain in hospitals, especially those regarding fear of addiction. Inclusion of pain interference with functional status as an outcome measure is a useful addition to ensuring optimal pain management. An aggressive public awareness campaign is necessary to positively impact health care policy regarding pain.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleEvaluation of a Comprehensive Pain Management Program in a Hospital Inpatient Settingen_GB
dc.identifier.urihttp://hdl.handle.net/10755/158302-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Evaluation of a Comprehensive Pain Management Program in a Hospital Inpatient Setting</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2003</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Dingmann, Colleen</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Colorado Health Science Center, School of Nursing</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Research Coordinator</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">4200 East 9th Avenue, Denver, CO, 90095-6917, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value"> 303.372.6310 </td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">colleen.dingmann@uchsc.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Fink, R.; Beezley-Hester, J</td></tr><tr><td colspan="2" class="item-abstract">Statement of the Problem: Recognition of a widespread inadequacy of pain management has prompted corrective efforts within multiple health care disciplines. The Joint Commission on Accreditation of Healthcare Organizations published standards for pain assessment and management in hospitals. A university hospital implemented a comprehensive pain management program, which included the identification of pain as the &ldquo;fifth vital sign&rdquo; and documentation requirements for all health care providers. This study evaluated the pain management program and explored the impact of pain interference with functional status and its usefulness as an outcome measure of optimal pain management. Theoretical Framework: This study was guided by Melzack&rsquo;s Neuromatrix theory and Roger&rsquo;s Diffusion of Innovation model. Sample: A random sample consisted of 386 inpatients pre- (1994) and 382 inpatients post-implementation (2002) of a comprehensive pain management program. Methods: A prospective comparative design was used to study inpatients who were experiencing pain and had been hospitalized for greater than 24 hours. An 18-item survey, previously developed and tested for reliability and validity, was used to survey inpatients&rsquo; knowledge and beliefs about pain, pain intensity, pain interference with functional status, pain expectations, and satisfaction with pain management. Medical records were reviewed for diagnoses, pain types, documentation of pain assessment, analgesic prescription and administration, use of non-pharmacological approaches, and presence of side effects. Findings: Descriptive statistics and tests of difference and association were used to analyze data. Demographics for both populations were similar. Pain intensity scores were not improved post implementation of the pain management program. There was no significant difference in current pain intensity, however, patients&rsquo; pain intensity within the past 24 hours, concern about addiction, and perception of their own involvement in pain management showed a significant increase (p&lt;0.01) post implementation. Nurses&rsquo; documentation of pain assessment significantly improved (p&lt; 0.01) but remained the same for physicians. Pain interfered with functional status (sleep, walking, mood, and relations with others) in greater than 75% of respondents. Pain intensity was moderately correlated with sleep and walking (p &lt; 0.01). Conclusions: Innovations in pain management practices must be developed to change the culture of persistent attitudes and beliefs about pain in hospitals, especially those regarding fear of addiction. Inclusion of pain interference with functional status as an outcome measure is a useful addition to ensuring optimal pain management. An aggressive public awareness campaign is necessary to positively impact health care policy regarding pain. </td></tr></table>en_GB
dc.date.available2011-10-26T20:42:38Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:42:38Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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